Tyler Christian Ege, LPC
Individual provider Active NPI Professional Counselor · Roscoe, IL
NPI 1619508124 · NPPES record last updated Feb 3, 2020
Key facts
- NPI
- 1619508124
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 178.015621 (IL)
- Practice address
- 5290 Williams Dr
Roscoe, IL 61073-9222 - Phone
- (815) 324-0324
- NPI assigned
- Feb 3, 2020
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 21, 2025 through Nov 21, 2027
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 178.015621 | IL | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 178.015621 | IL | Yes |
Addresses
Primary practice location
5290 Williams Dr
Roscoe, IL 61073-9222
Mailing address
387 Mill St
Batavia, IL 60510-9249
Phone (815) 793-5697
Other providers in Roscoe, IL
- Nathan Dufoe
- Matthew C Dziarski
- East West Chiropractic Health Center LTD
- Daniel Eberdt
- Jeanette Marie Edie
- Emil Mommers P.C.
- Joshua Entenman
- Shaghayegh Esfandnia
- Janice Marian Ethington
- Afoma Phoebe Ezidinma
All providers in Roscoe, IL · Professional Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 3, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.